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Background: Dental caries, commonly known as tooth decay is a widespread oral health problem mainly attributed to the activity of cariogenic bacteria, such as Streptococcus mutans and Lactobacillus species. Tooth Mousse, containing remineralizing agents, herbal and fluoride containing toothpaste with antimicrobial agents have been developed to target cariogenic bacteria. Herbal, fluoride toothpaste, and Tooth Mousse are commonly prescribed to prevent, reduce, and control dental caries., Aim: This study aims to analyze the effect of Tooth Mousse and medicated toothpastes on S. mutans and Lactobacillus acidophilus using direct contact test., Methodology: L. acidophilus and S. mutans were cultured on Mueller-Hinton agar (MHA-Hi media) using sterile cotton swabs and plates were dried for 15 min. Toothpastes (Dabur Red, Pepsodent) and Tooth Mousse were used at 1:1 dilution using sterile pyrogen-free distilled water. Fifty microliter of toothpastes and Tooth Mousse were introduced into each well. The plates were incubated at 37°C for 24 h., Results and Discussion: The antimicrobial activity was evaluated by measuring the diameter of zones of inhibition (mm). The toothpaste containing fluoride (A) showed greater zone of inhibition compared to herbal toothpaste (B) whereas Tooth Mousse (C) did not show any zone of inhibition., Conclusion: Among herbal and fluoride toothpaste, fluoride containing toothpaste showed more zone of inhibition thereby attributing to its increased antimicrobial property on S. mutans and L. acidophilus., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Conservative Dentistry and Endodontics.)

Introduction: Vitamin D performs various functions as a hormone by promoting calcium absorption but plays a major role in innate immunity,cell differentiation, cell maturation through its genomic effects via vitamin D receptor. The immune response also plays a major role in tooth surface and supporting structure destruction and playing a major factor in high caries formation. The inflammatory cytokines are released has proinflammatory cytokines and stimulate cells in disease process. Therefore, in the present study we have evaluated the association of salivary vitamin D, LL-37, interleukins 6 and 17A in various levels of severity of dental caries., Method: Ethical approval was obtained (NU/CEC/2020/0339), 377 individuals reporting to department of conservative dentistry and endodontics, AB Shetty memorial institute of dental sciences were included based on inclusion criteria. The individuals were further divided into caries free(N = 105) and caries active(N = 272) based on their caries prevalence. The salivary were collected and evaluated for vitamin D, LL-37,IL-17A and IL-6.Results were statistically analysed with SPSS vs 22 (IBM Corp, USA). Normally distributed data were expressed as mean ± SD. Skewed data were expressed as median and interquartile range. To compare (mean) outcome measures between the two groups unpaired independent t-test was applied and for values in median IQR, Mann Whitney U test was used. All statistical analysis for P value were two-sided and significance was set to P ≤ 0.05., Results: The study showed that, the salivary vitamin D statistically decreased with increasing severity of caries which showed that vitamin D plays an important role in prevention of caries. Antimicrobial peptide LL-37 was higher in caries free group but was not statistically significant, salivary IL-6 level was higher in caries active group but intergroup comparison did not show significant difference. Salivary IL-17A did not show statistically significant between caries active and caries free group., Conclusion: The salivary levels of vitamin D may play a vital role in prevalence of dental caries and its severity which can be a underlying cause in presence of other etiological factors., (© 2024. The Author(s).)

Objective: The objective of this study was to study the effect of medicated toothpaste on oral health, a 6-month follow-up., Methods: Four hundred and twenty-seven participants were screened and followed up for 6 months. The intraoral examination was performed to record caries, gingival bleeding, and plaque index. Saliva collected was evaluated for pH, total antioxidant capacity (TAC), malondialdehyde (MDA), and Vitamin C level for 6 months, and data were analyzed., Results: On the usage of medicated toothpaste with herbal extract for 6 months, the salivary pH levels were increased, the interquartile range for plaque, and the gingival bleeding index decreased. The percentage change in salivary TAC, MDA, and Vitamin C levels in the caries-free group of subgroup I was 174.8, 58.06, and 59.98, respectively, in subgroup II was 133.3, 52.08, and 58.51, and in subgroup III was 63.77, 45.11, and 47.77. The percentage change in salivary TAC, MDA, and Vitamin C levels in the caries-active group of subgroup I was 136.62, 57.27, and 72.83, subgroup II was 108.59, 37.50, and 61.55, and in subgroup III was 35.62, 30.82, and 54.10, respectively., Conclusion: The salivary pH levels increased on the usage of medicated toothpaste with herbal extract; plaque and the gingival bleeding index scores were decreased. The salivary antioxidant defense was increased in individuals using medicated toothpaste with herbal extracts which signifies an improvement in overall oral health in the 6-month follow-up., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Conservative Dentistry.)

Aim To evaluate the efficacy of ozonated water as an irrigant in disinfection of the root canal system.Materials and methods This systematic review was conducted according to PRISMA guidelines and methodological studies were assessed through the Cochrane Risk of Bias tool. All studies on extracted human teeth using ozonated water were considered for the study, whereas ex vivo studies, studies on animal dentition and studies which were published in languages other than English were excluded from the study. The search was carried out on various databases such as PubMed, Google Scholar and ScienceDirect within the last 15 years. The assessment of quality of the studies was performed under the following: 1) size of sample; 2) control group; 3) standardisation of procedure; 4) statistical analysis performed; 5) risk of bias.Results There were a total of 154 study results, out of which duplicates and full-text analysis were excluded. A total of seven studies were included in the systematic review. The results in one study by Cardoso et al. showed ozonated water was better at reducing microbial counts, while two other studies demonstrated the difference in reducing microbial counts when comparing ozonated water against other irrigants. The remaining four studies concluded that ozonated water did not perform better as compared to the other irrigants such as sodium hypochlorite and chlorhexidine.Discussion It could be concluded that ozonated water is not a better disinfecting irrigant than sodium hypochlorite and chlorhexidine in the disinfection of the root canal system; however, it had an almost comparable level of disinfection., (© 2022. The Author(s), under exclusive licence to the British Dental Association.)

To review the analytical methods for carious and erosive demineralization an initial search of peer-reviewed scientific literature from the digital library database of PubMed/Medline indexed journals published up to early 2022 was carried out based on keywords relevant to the topic criteria including bibliographic citations from the papers to gather the most updated information. This current review aims to provide an updated overview of the advantages, limitations, and potential applications of direct and indirect research methods available for studying various dynamic stages of carious and erosive demineralization in enamel and dentin. This paper categorizes and describes the most suitable, frequently adopted and widely used quantitative and qualitative techniques in in vitro / in vivo research which are well-established, emerging, or comparatively novel techniques that are being explored for their potential validation., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Conservative Dentistry.)

Background: Understanding the influence of age on growth kinetics and telomere length in dental stem cells is essential for the successful development of cell therapies. Hence, the present study compared the basic cellular and phenotypical characteristics of stem cells from human exfoliated deciduous teeth (SHEDs) and dental pulp stem cells (DPSCs) of permanent teeth and their telomere lengths using quantitative real-time polymerase chain reaction., Materials and Methods: The study is an in vitro original research article. Primary cultures of SHED and DPSCs ( n = 6 each) were successfully established in vitro , and the parameters analyzed were the morphology, viability, proliferation rate, population doubling time (PDT), phenotypic markers expression, and the relative telomere lengths. Data were analyzed by analysis of variance and P < 0.05 was considered statistically significant., Results: SHED and DPSCs exhibited a small spindle-shaped fibroblast-like morphology with >90% viability. The proliferation assay showed that the cells had a typical growth pattern. The PDT values of SHED and DPSCs were 29.03 ± 9.71 h and 32.05 ± 9.76 h, respectively. Both cells were positive for surface markers CD29, CD44, and CD90. However, they were negative for CD45 and human leukocyte antigen DR. Although the differences in relative telomere lengths between the individual cell lines of SHED and DPSCs were observed, no significant ( P > 0.05) variations were found for the mean T/S ratios of both the cells., Conclusion: SHED and DPSCs displayed similar morphology, proliferation rates, and phenotypic features. The relative telomere lengths were slightly shorter in DPSCs than SHED, but the values were not significantly different. Thus, SHED and DPSCs can be considered as recognized sources for regenerative applications in dentistry., Competing Interests: The authors of this manuscript declare that they have no conflicts of interest, real or perceived, financial or nonfinancial in this article., (Copyright: © 2022 Dental Research Journal.)

The prevalence of dental caries in individuals who practice good oral hygiene increasingly indicates that other etiological factors, such as genetic factors, may be responsible for occurrence of caries, and its prevalence in younger individuals, such as adolescents, is an early manifestation of their genetic makeup. Therefore, there is a need to investigate the correlation of various genetic factors with the occurrence of dental caries in populations. Thus, this study assessed the relationship between single nucleotide polymorphism (rs2228570) in the vitamin D receptor gene and dental caries susceptibility. After obtaining ethical approval (NU/CEC/2020/0339), 377 adults, aged 18-40 years, were included in this study. Among the participants consenting to participate, salivary samples were collected, and an oral examination was conducted using the World Health Care Oral Health Survey Format 2013. The DMFT and PUFA index scores were recorded along with basic demographic details. The subjects were categorized as caries-free (controls, DMFT = 0) and caries-active (cases). The case group was further divided into the high-risk group (DMFT ≤ 10), moderate-risk group (DMFT = 4-9), and low-risk group (DMFT = 1-3). Saliva samples were used for vitamin D level analysis and DNA isolation. Polymerase chain reaction-based restriction fragment length polymorphism analysis using Fok1 digestion was performed on the isolated DNA. Salivary vitamin D levels were markedly higher in the caries-free group than in the caries-active group ( p < 0.001). The T allele of rs2228570 was significantly associated with having active caries, while the C allele was associated with being caries-free. Individuals with the rs2228570 TC genotype had 2.814-fold increased likelihood, and individuals with the TT genotype had 3.116- fold increased likelihood of being caries-active. This finding is important in terms of patient counselling, as well as possibly in terms of prevention and treatment of caries., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Nireeksha Nireeksha et al.)

Limiting the spread of virus during the recent pandemic outbreak was a major challenge. Viral loads in saliva, nasopharyngeal and oropharyngeal swabs were the major cause for droplet transmission and aerosols. Saliva being the major contributor for the presence of viral load is the major key factor; various mouthwashes and their combination were analyzed and utilized in health care centers to hamper the spread of virus and decrease viral load. The compositions of these mouthwashes to an extent affected the viral load and thereby transmission, but there is always a scope for other protocols which may provide better results. Here we evaluated the potential of antimicrobial peptide LL-37 in decreasing the viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through an in silico work and evidence from other studies. This narrative review highlighted a brief nonsystematic methodology to include the selected articles for discussion. Accessible electronic databases (Medline, Scopus, Web of Science, SciELO, and PubMed) were used to find studies that reported the salivary viral load of SARS-CoV-2 published between December 2019 and June 2021. The following keywords were utilized for brief searching of the databases: "saliva," "viral load," and "SARS-CoV-2." Articles in English language, in vitro cell-line studies, ex vivo studies, and clinical trials explaining the viral load of SARS-CoV-2 in saliva and strategies to decrease viral load were included in this review. The search was complemented by manual searching of the reference lists of included articles and performing a citation search for any additional reviews. The antiviral potential of cationic host defense peptide LL-37 was evaluated using computational approaches providing in silico evidence. The analysis of docking studies and the display of positive interfacial hydrophobicity of LL-37 resulting in disruption of COVID-19 viral membrane elucidate the fact that LL-37 could be effective against all variants of SARS-CoV-2. Further experimental studies would be needed to confirm the binding of the receptor-binding domain with LL-37. The possibility of using it in many forms further to decrease the viral load by disrupting the viral membrane is seen., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Introduction: Irrigants play an important role in the eradication of microorganisms in the complex root canal system. Sodium hypochlorite (NaOCl), chlorhexidine (CHX), and iodine potassium iodide (IKI) have certain limitations despite their routine clinical use. Surfactant irrigants with antimicrobial properties can be a milestone in endodontics to overcome the drawbacks of conventional irrigants. The aim of this study was to evaluate the antimicrobial efficacy of surfactants in comparison with routine endodontic irrigants on Enterococcus faecalis ., Materials and Methods: Primary irrigants NaOCl, CHX, IKI were prepared at concentrations of 5%, 2.5%, 2%, and 1%; while mixture of tetracycline acid and detergent (MTAD) (100%) served as control group. Surfactants such as cetrimide (CTR) and sodium dodecyl sulfate (SDS) were prepared at concentrations of 0.5%, 1%, and 2%. The direct contact assay was used to evaluate the antimicrobial efficacy after 5 min. Statistical analysis was performed using one-way ANOVA and Mann-Whitney U -test., Results: In the primary group, only 5% CHX was significant over MTAD ( P < 0.05). In the surfactant group, all concentrations of CTR and SDS (except 0.5%) were significant ( P < 0.05) in killing E. faecalis over MTAD. Two percent CHX in combination with 0.5% CTR and 1% SDS had an effective kill percentage over 2% CHX and MTAD alone., Conclusion: Surfactant irrigant regimens can be used as adjuncts with CHX to overcome its clinical limitations and potentiate its substantivity, thereby enhancing clinical success in endodontics., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Contemporary Clinical Dentistry.)

Introduction: Chlorhexidine (CHX) is a commonly used root canal irrigant with high surface tension which prevents its penetration into the isthmus and fins of the root canal. Surfactants have known to reduce the surface tension of the liquid. Cetylpyridinium chloride (CPC) is a cationic surfactant. The aim of this study is to assess the contact angle formed and depth of penetration of the endodontic irrigant with and without the addition of surfactant., Methods: Contact angle analysis - Ninety-nine freshly extracted and cleaned single-rooted mandibular premolars were obtained. Thirty-three teeth were sectioned longitudinally and then transversely. The sections were mounted on an acrylic block, polished to obtain a flat dentin surface. Five microliter of Group 1: 2% CHX as control, Group 2: 2% CHX + 0.1% CPC, and Group 3: 2% CHX + 0.2% CPC were placed on the dentin surface and subjected to contact angle analysis. Depth of penetration - Access cavity was prepared in sixty-six teeth and instrumented to working length till Protaper Gold F2. The samples were assigned to Groups 1, 2, and 3 and irrigated accordingly, and subjected to a confocal laser scanning Microscopy. Data were analyzed using one-way ANOVA and Tukey multiple comparison test. Karl Pearson's correlation test was performed to analyze the correlation between the two., Results: Group 3 had the lowest contact angle (12.82°) and the highest depth of penetration (222.74 μm) when compared to Group 1 and Group 2. Karl Pearson's correlation showed no correlation between the contact angle and the depth of penetration., Conclusion: Higher the concentration of CPC, lower is the contact angle formed with the dentin and higher is the depth of penetration into the dentinal tubule., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Conservative Dentistry.)

Objective: The research for analyzing the smile characteristics in the Indian population has been limited with contradictory outcomes. This consensus statement aims to critically review the literature and provide basic practice guidelines on dental aesthetics related to the Indian population., Clinical Considerations: 9 clinicians and 6 resource persons from dental colleges in India collaborated in this consensus statement which covered 6 topics along with 6 introductory and 6 conclusive remarks. The statement was developed through a colloquium conducted on topics; global aesthetics: different smile design proportions and guidelines, patient perspective towards aesthetic dentistry in India, a literature survey of aesthetic dentistry for the Indian population, macro and micro-aesthetics, multidisciplinary approach in aesthetic dentistry, inclusion of high-end technologies in Indian modern-day practice, followed by a panel discussion to devise and establish the practice guidelines of aesthetic dentistry in India. The Consensus Statement has been formulated according to AGREE Reporting checklist., Conclusion: The experts and panelists reached a Consensus on protocols to institute clinical practice guidelines of aesthetic dentistry for Indians. However, based on all available literature from India, further research is required to investigate many questions that have not been previously considered., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Conservative Dentistry.)

Background: With the increasing prevalence of erosive tooth wear affecting both adults and children; designing optimum protocols of management in a noninvasive manner is gaining precedence., Aim: Comparative evaluation of topically applied calcium phosphate-based agents casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and beta tricalcium phosphate (β-TCP) on the surface of eroded dentin., Materials and Methods: Dentin blocks from human third molars in four groups were subjected to the surface treatment: (G1) sound dentin (G2) demineralized dentin (G3) CPP-ACP (G4) β-TCP. All the samples except control (G1) were immersed in an acidic solution incubated at 37°C for 96 h. The samples in G3 and G4 were topically treated with CPP-ACP and β-TCP for 4 min twice daily for 14 days; followed by pH-cycling for 21 days. Surface hardness testing and surface morphology were observed using the scanning electron microscopy. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software with Kruskal-Wallis test and post hoc test., Results: Dentin treated with both CPP-ACP (37.25) and β-TCP (32.05) recorded significantly higher VHN than demineralized (G2-23.51) but lower compared to sound control (G1-57.06)., Conclusion: The topical application of CPP-ACP and β-TCP agents shows definite potential in promoting the hardening of demineralized dentin surface., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Conservative Dentistry.)

Aim: Coronavirus disease 2019 (COVID-19) being declared a global public health emergency has become a significant challenge for all healthcare workers, including dentistry, recognised as a high-risk profession during these times. This consensus statement aims to highlight and provide guidelines necessary to be implemented for a clinical dental practice., Materials and Methods: A total of nine conservative Dentists and Endodontists and one Oral and Maxillofacial Surgeon; with four panelists from government dental colleges, one each from the North, South, East and West India and six resource persons from private colleges in South India, all of them being clinicians and administrators practicing dentistry since the inception of the pandemic, collaborated in this consensus statement. The consensus statement was developed through a symposium conducted on the topics; general dental practice during COVID-19 times, the importance of aerosols in clinical dental practice in the spread of COVID-19, effective standard operating protocols for clinical dental practice and Institutional settings with scientific evidence-based justifications, followed by a panel discussion with to devise mandatory protocols to be followed in clinical and institutional settings. The symposium was attended by 46 practitioners who participated in the deliberation., Results: This consensus statement provides clinicians and researchers with protocols for the dental practice, agreed upon by experts in the field. The Consensus Statement has been formulated according to the AGREE Reporting checklist for the formulation of guidelines., Conclusion: The experts and panelists reached a Consensus on the protocols and guidelines for the safe clinical and institutional dental practice., (© 2021 John Wiley & Sons Ltd.)

The role of inflammatory mediators in dental pulp is unique. The local environment of pulp responds to any changes in the physiology that are highly fundamental, like odontoblast cell differentiation and other secretory activity. The aim of this review is to assess the role of cathelicidins based on their capacity to heal wounds, their immunomodulatory potential, and their ability to stimulate cytokine production and stimulate immune-inflammatory response in pulp and periapex. Accessible electronic databases were searched to find studies reporting the role of cathelicidins in pulpal inflammation and regeneration published between September 2010 and September 2020. The search was performed using the following databases: Medline, Scopus, Web of Science, SciELO and PubMed. The electronic search was performed using the combination of keywords "cathelicidins" and "dental pulp inflammation". On the basis of previous studies, it can be inferred that LL-37 plays an important role in odontoblastic cell differentiation and stimulation of antimicrobial peptides. Furthermore, based on these outcomes, it can be concluded that LL-37 plays an important role in reparative dentin formation and provides signaling for defense by activating the innate immune system.

Introduction: The butterfly effect is an optical phenomenon and is related to the presence of sclerotic dentin in the roots. The unique pattern of sclerotic dentin formation produces a characteristic butterfly shape in transverse sections of the roots. The objective of this study was to evaluate the direction of the fracture line in roots that exhibit the butterfly effect., Methods: Thirty single-rooted premolars with oval-shaped roots were decoronated and embedded in acrylic blocks and subjected to vertical force under a universal testing machine (HPBSD; Tec-Sol India, Chennai, India). Fractured roots were examined under a stereomicroscope (Model no. 080772; Lawrence and Mayo, Mumbai, India) at ×10 magnification to determine the location and direction of the fracture line. To evaluate the correlation between the direction of sclerotic dentin and the direction of the fracture line, teeth were sectioned and observed under a stereomicroscope at ×20 and ×40 magnification. The correlation was analyzed using the Fisher exact test (P < .05 for the coronal and apical thirds and P > .05 for the middle third)., Results: Sclerotic dentin was observed more in the apical area and less in the coronal third of the root. The correlation between the direction of sclerotic dentin and the direction of the fracture line was statistically significant in the coronal and apical thirds of the root., Conclusions: The vertical root fracture that runs buccolingually is correlated to the harder sclerotic dentin present in the mesiodistal direction., (Copyright © 2021 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Aims: This study aims to evaluate the bond strength (BS) and microleakage (ML) of the newer bonding agents to enamel and dentin., Objective: (1) To analyze the BS between self-etch and total-etch adhesives. (2) To analyze the depth of ML between self-etch and total-etch adhesives., Materials and Methods: Sixty mandibular premolars were fabricated and randomly divided into three groups: Group I ( n = 20)-bonded with self-etch adhesive + nanohybrid, Group II ( n = 20) with total-etch adhesive + micro hybrid and Group III ( n = 20) with total-etch adhesive + nanocomposite. Teflon ring molds were used to make composite resin cylinders bonded to the buccal surface. Class II box cavity was prepared on the samples' proximal surface and condensed with composite resin with each group's specific bonding protocol. Shear BS and ML testing were conducted, and data analyzed., Statistical Analysis: Kruskal-Wallis analysis was done to statistically differentiate the BS and ML between the three experimental groups; the P < 0.05, it showed a statistically significant difference. Intergroup comparison was made using the Mann-Whitney U test., Conclusions: Within this study's limitation, resin bonded with self-etch G-Premio Bond used in selective etch technique showed the highest BS and resistance to ML., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Conservative Dentistry.)

Aim: To compare the stress distribution of four modalities of reinforcing the radicular space of a pulpless central incisor exhibiting stage 4 root development., Materials and Methods: The model of a pulpless immature central incisor with a stage 4 of root development supporting periodontium was generated based on the properties. The longitudinal growth of the root was completed. Four such models were developed. Then, the radicular space was rehabilitated as follows: Model 1: Ceramicrete; Model 2: Biomimetic Mineralization; Model 3: Biodentine; Model 4: Bioaggregate. They were subjected to three different loading conditions. One was to mimic the mastication by applying a load of 70 N applied at 45° angle. Second loading condition was a vertical load of 100 N to mimic bruxism. The third loading condition was to mirror the impact of a frontal trauma. A load of 100 N was applied labially., Results: It was observed that during mastication, Model 2 has exhibited the lowest concentration of von Mises stresses, followed by Model 3 and then Model 4 followed by Model 1; this could be because the modulus of elasticity of Model 2 is comparable to that of Dentin. During bruxism and horizontal impact, the maximal stress concentration was found in Model 4, Model 3, Model 2, followed by Model 1., Conclusion: The closer the elasticity of modulus of the primary endodontic replacement monoblock was to that of dentin, the lower were the stresses generated. However, as the increase in stress values was minimal between groups, these obturating materials can be viable reinforcement materials for the rehabilitation of cases of stage 4 developing root. Biomimetic mineralization strategies can be a viable treatment option for managing cases of the open apex., Clinical Relevance: Biomimetic mineralization strategies and bioceramics can be used for obturation of root canals with open apex, instead of utilizing these bioceramics as apical plugs.

Background. Bioceramics need to interact chemically with dentin to exhibit adequate bioactivity. Proper bonding of bioceramics with dentin is of considerable importance. This study aimed to evaluate the wettability and marginal adaptation of bioceramics after the use of surface-active agents on dentin: %0.5 cetrimide and %1 alkylbenzene sulfonate. Methods. Of ninety maxillary central incisors, 45 teeth were sectioned longitudinally with 45 root halves randomly assigned to three groups (n=15): group I: no pre-treatment; group II: %0.5 cetrimide; group III: %1 alkylbenzene sulfonate. Then, the samples were subdivided into three subgroups (n=5): subgroup I: MTA; subgroup II: Biodentine, and subgroup III: BioRoot. A controlled-volume droplet of bioceramic material was placed on each root half, which was positioned in a dynamic contact angle analyzer to record the static contact angle for wettability. The remaining 45 samples were decoronated; the root canals were prepared and randomly categorized, as mentioned above. The root canal surfaces were treated, filled with the bioceramic material, transversely sectioned, and then each middle section was analyzed microscopically for marginal adaptation. Statistical tests used included post hoc Tukey tests and one-way ANOVA. The level of statistical significance set at %95 (P<0.05). Results. The contact angle values and interfacial gap width values after surface pre-treatment were significantly lower when compared to no pre-treatment group (P<0.05). The values were significant for %0.5 cetrimide in the case of Biodentine and %1 alkylbenzene sulfonate in the case of BioRoot (P<0.05). Conclusion. The two surfactants yielded promising results for enhancing the wettability and marginal adaptation of materials to the root dentin, which is required for obtaining an adequate seal, penetration, and bond strength of bioceramics., (© 2020 The Authors.)

Introduction: Failures of root canal treatments are mainly attributed to missed canals and ignorance about the complex anatomy of the root canal system. One such example of anatomic variation is the middle mesial canal (MMC) in mandibular molars which is often missed, and literature on methods for identifying them is limited., Aim: This in vitro study aimed to assess the occurrence of MMCs with cone-beam computed tomography (CBCT) and then under magnification in the mandibular first and second molars., Materials and Methodology: A total of 120 extracted intact human permanent mandibular first and second molars were selected. These were subjected to CBCT imaging and magnification for the detection of MMCs. The percentage of incidence in the detection of MMC was compared between these two methods., Results: The incidence of MMC detected in mandibular molars using CBCT was 13.33% (16 of 120 teeth), while using a dental operating microscope, the incidence was 18.33% (22 of 120 teeth) and the comparison between the two methods was statistically not significant. The MMCs were classified based on the Pomeranz Classification. The most prevalent canal configuration was a confluent type which was found to be in 72% cases (16 of 22), followed by fin type which was 22.7% (5 of 22) and independent type was only 4.54% (1 of 22). The incidence of the location of MMC orifice was studied. In 50% of the cases, orifice was located closer to the mesiolingual canal, whereas in 27% of the cases, it was closer to the mesiobuccal canal and in 4.95% of the cases, it was detected midway., Conclusions: Since the incidence of MMC was higher with the use of a microscope, it is preferred to use simpler, chairside aids like magnification and ultrasonic troughing. On the other hand, one should be judicious while subjecting a case to preoperative CBCT evaluation owing to its ionizing radiation., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Conservative Dentistry.)

The COVID-19 pandemic, still on the growth curve, has had a devastating effect on the dental health sector for the past 3 months. This has become an area of enormous concern for the dentists professionally and the patients in terms of dental health. Dentistry at this point needs a complete structural change to prevent cross-infection among the patients and dentists owing to the unique characteristic of a dental health-care setting as well as to offer a sense of safety and security to the patients. This article highlights the salient points to be considered for the post-COVID phase in dentistry., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Conservative Dentistry.)

Introduction: An array of factors control the success of endodontic surgery. One of them is the technique used to prepare the root end cavities which is conventionally being done with burs. In past decades, ultrasonic instruments have been introduced for the same. Studies comparing these instruments on root surface integrity are scarce. Thus, an in-vitro Scanning Electron Microscopy study was designed to evaluate the surface integrity of root end cavities prepared using conventional and piezoelectric devices., Methodology: Twelve single-rooted human intact mandibular premolar teeth were endodontically treated and included in the study. They were divided into two groups. In the first group, 3 mm root-end cavities were prepared using conventional retro preparation burs and in the second group, 3 mm root-end cavities were prepared using piezoelectric retro-tips. The specimens were coded for blind evaluation and analysed under scanning electron microscope at 100x, 500x and 1000x magnification for smear layer and debris. Gutmann's scoring criteria was followed to score the specimens. Statistical analysis was carried out using Shapiro Wilk test and the independent sample t-test was used to check mean differences between variables., Results: It was noted that significant statistical differences existed in mean debris and smear layer scores (p< 0.001) between the two groups. In the piezoelectric group, significantly lower debris layer and smear layer was found, compared to the conventional bur group., Conclusion: Root-end cavities prepared using piezo retrotips produced cleaner, well-centered and more conservative surface with minimal debris & smear layer, compared to root-end cavities prepared using conventional burs., Competing Interests: None

Introduction: Irradiation is known to cause oxidation process among the tissue-altering the properties of teeth leading to tissue necrosis and caries formation. Hence protection of the oral cavity is a major concern to deal with therapy side effects., Aim: Evaluation of wear resistance property of Enamel against electron beam radiation and analysing the radio protective effects of natural organic compounds., Materials and Methods: Total of 36 healthy extracted human molar teeth were collected, four samples were used as control, and remaining 32 were divided into four groups ( N  = 8 each): radiation control group and three groups treated with organic compounds during radiation treatment. The enamel samples were tested for FTIR spectroscopy, XRD analysis, SEM and EDAX analysis before and after 70 Gy radiation treatment., Results and Discussion: The particle size of radiation control samples had increased showing decrease in its crystallinity index. Calcium to Phosphorous ratio had also decreased along with structural changes as observed by SEM analysis. But groups treated with organic compounds has maintained tooth integrity in comparable to control groups after radiation treatment., Conclusion: Virgin coconut oil, vitamin E oil and curcumin has potential radioprotective action against radiation in protecting tissue properties. Hence, with further advanced research, these natural substances should emerge as a topical applicator during radiotherapy to oral cancer patients., Competing Interests: Competing interestsThe authors declare no competing interests.

Aim: The aim of this study is to evaluate the pushout bond strength of two bioceramic materials, two component calcium trisilicate material (biodentine), and premixed calcium trisilicate putty (Endosequence root repair material-fast set putty)., Subjects and Methods: 20 maxillary incisors were used in the study. Apical sections of 3mm were obtained and retro cavities to a depth of 3mm were prepared using a straight fissure bur. Another transverse section was made 4-mm coronal to the previous section. The specimens were placed into acrylic resin rings and separated into two groups and their cavities filled with the materials. The pushout test was carried out using a universal testing machine at a cross head speed of 0.5 mm/min, and the specimens were examined in a stereomicroscope at to evaluate the modes of failure., Statistical Analysis: The pushout bond strength values were analyzed using the unpaired t -test, and the modes of failure were compared using Fisher's exact test., Results: The pushout bond strength was seen to be significantly higher ( P < 0.001) for the two-component calcium trisilicate material (11.596 ± 3.309). Cohesive failure patterns were observed in both the test groups., Conclusion: Two component calcium trisilicate material demonstrated higher bond strength values to apical dentine., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Journal of Conservative Dentistry.)

Aim: The aim of the present review article is to establish a systematic review to describe the role of various salivary components such as pH, buffering capacity, proteins, electrolyte, antioxidant, enzymes, and minerals in occurrence and initiation of dental caries in participants with and without dental caries., Methodology: An electronic search was conducted in the PubMed, Scopus, Web of Science, and Google Scholar databases. The MESH terms (Medical Subject Headings) were "dental caries susceptibility," "caries risk assessment, "Salivary Biomarker," "saliva," "Proteins," "electrolytes," "biomarker," "Anti-oxidant's." The database search was limited to the studies published between 2008 and 2018 and only human studies were included. Furthermore, the STROBE criteria checklist was used to analyze the studies which had to be included in the systematic review., Results: A total of 150 articles were retrieved through electronic database. After evaluating the title, abstract, and full text of these articles, only 11 were selected for the present systematic review. However, two articles were excluded because they were classified as high risk of bias according to the STROBE criteria. Out of 9 studies selected, 5 were classified as low-risk bias and 4 were classified as moderate-risk bias., Conclusion: Based on the results of the systematic review, out of 11 studies, 7 found to have a statistically significant difference between individuals with and without caries experience. Hence, it can be concluded that there is an association between various components of saliva and dental caries., Competing Interests: There are no conflicts of interest.

Background: Vancomycin-resistant enterococci (VRE) are on the rise globally in primary intraradicular infections and resistant to most intracanal irrigants and medicaments. The aim of this study was to evaluate the efficacy of irrigants and identify a cost-effective regimen to eradicate VRE., Materials and Methods: In this in vitro study irrigants were categorized as primary and surfactant groups with individual concentrations consisting of 10 samples each. Primary irrigants; sodium hypochlorite (NaOCl), chlorhexidine (CHX), and iodine potassium iodide (IKI) were prepared in concentrations of 5%, 2.5%, 2%, and 1%. Surfactants cetrimide (CTR) and sodium dodecyl sulfate (SDS) were prepared in concentrations of 0.25%, 0.5%, 1%, and 2%. Biopure MTAD was chosen as the control group. ATCC 51299 (VRE) was evaluated for antimicrobial susceptibility to the above irrigants by direct contact test for 5 min. The effect of each test irrigant was determined by calculating the percentage kill of viable bacteria by spectrophotometer. Statistical analysis was done by means of a one-way ANOVA and Mann-Whitney U-test ( P < 0.05 consider significant)., Results: About 2.5% and 5% CHX were significant over mixture of tetracycline, acid and detergent (MTAD) ( P < 0.05). 5% CHX could achieve 100% elimination while 2.5% CHX and 5% IKI had 99.90%. 2% CHX and 2.5% IKI had 99% effective kill percentage. All concentrations of NaOCl were ineffective (90%) as compared to MTAD (95%). CTR (0.5%, 1% and 2%) and SDS (2%) were significant ( P < 0.05) over MTAD. Combination surfactant regimens of 2% CHX +0.5% CTR and 2% CHX +1% SDS achieved 99.90% eradication potential and were significant ( P < 0.05) over MTAD., Conclusion: Surfactant regimens were highly effective and superior to MTAD. CTR and SDS by their organic solvent property enhanced the antibacterial action of CHX., Competing Interests: The authors of this manuscript declare that they have no conflicts of interest, real or perceived, financial or nonfinancial in this article.

Aims: The aim of the present study was to evaluate the efficacy of reverse rotary instrumentation in disinfection of the root canal at the apical third and qualitative confirmatory analysis using the scanning electron microscope (SEM)., Subjects and Methods: Sixty single-rooted mandibular premolars were instrumented up to Protaper rotary file size F2 and contaminated with a known species of Enterococcus faecalis (ATCC 29212). The samples were then divided into three groups; Group 1: Experimental group-irrigation by agitation of 1% NaOCl with reverse rotary instrumentation; Group 2: Negative control-no irrigation; and Group 3 positive control-irrigation with 1% NaOCl using a 30-gauge needle. The colony forming units of all the groups were checked. SEM analysis of the samples was focused on the apical third to confirm the absence of E. faecalis biofilms. The data obtained were statistically analyzed by the Fisher's exact test and Pearson's Chi-square test., Results: Group I and III showed significant reduction in the growth of E. faecalis (P ≤ 0.001). SEM confirmed dense bacterial colonies in the Group II consistent with biofilm formation and reduction in bacterial colonies in Group I and II., Conclusion: Agitation with reverse rotary instrumentation in the apical third of the root canal along with 1% sodium hypochlorite proved effective in disinfection of the apical third of the root canal, which was further confirmed by scanning electron microscopic analysis. Hence, it can be used as an adjunct during rotary instrumentation in efficient cleansing of the root canal system in the apical third of the root canal system., Competing Interests: There are no conflicts of interest

Background: Effective management of smear layer ensures adequate clinical success. Use of sodium hypochlorite (NaOCl)/ethylenediaminetetraacetic acid regimen has been the gold standard with limitations. Commercial irrigants incorporate surface modifiers to address these drawbacks. The aim of this study was to evaluate the cytotoxicity of combination regimens on target and nontarget cell lines by trypan blue assay., Materials and Methods: Nonsurfactant combination regimen of chlorhexidine (CHX) and NaOCl (2% CHX + 2.5% NaOCl) and surfactant regimens of CHX with cetrimide (CTR) (2% CHX + 0.5% CTR) and CHX with sodium dodecyl sulfate (2% CHX + 1% SDS) were prepared. 0.9% normal saline (NS) and Biopure MTAD (100%) served as control. Cytotoxicity was evaluated on human gingival fibroblast (HGF) and Henrietta Lacks (HeLa) cell lines by trypan blue assay. Thirty microliter of the cell suspension was treated with 20 μl of irrigants. The cell suspension was loaded into Neubauer chamber after 5 min and cell count was performed under inverted microscope and expressed as viability percentage., Results: Nonsurfactant combination comprising of 2% CHX + 2.5% NaOCl formed a brownish precipitate while surfactant combination regimes were stable without any precipitate formation. NS and 2% CHX + 0.5% CTR had greater viability scores on both cell lines. Two percent CHX + 1% SDS had better viability on HeLa but were severely cytotoxic on HGF. Two percent CHX + 2.5% NaOCl and MTAD were found to be severely cytotoxic on HeLa with limited viability on HGF., Conclusion: The variation in data obtained could be possibly attributed to the difference in the cellular membrane composition and mechanism of action of combination regimens. Experimental surfactant regimen 2% CHX + 0.5% CTR shows lower cytotoxicity than MTAD., Competing Interests: There are no conflicts of interest.

Aim: The aim and objective of this study was to evaluate and compare the sealing ability of EndoSequence BC RRM-fast set putty, Proroot mineral trioxide aggregate (MTA), and Zirconomer in the repair of furcal perforation by measuring dye leakage under stereomicroscope., Methodology: A standard access cavity was made on forty-eight extracted mandibular and maxillary first molars followed by creating a furcal perforation in the center of the pulp chamber by using No. 4 round bur (creating a perforation of 2 mm diameter). Teeth were categorized into 4 groups containing 12 samples in each group based on material used for furcation repair. Group 1 - Endosequence BC RRM-fast set putty; Group 2 - Zirconomer; Group 3-MTA (positive control); Group 4 - negative control. All groups were covered with two layers of clear varnish except for 2 mm around the perforation region. All the teeth were immersed in 2% methylene blue dye for 48 h for dye penetration. Teeth were sectioned buccolingually using a diamond disk. The sectioned teeth were examined under stereomicroscope with ×10 magnification for dye penetration., Results: Endosequence showed less microleakage than MTA but not statistically significant. Zirconomer showed statistically significant higher microleakage., Conclusion: Endosequence and MTA showed less microleakage hence can be used as furcation repair materials. Due to higher microleakage, Zirconomer should be avoided as furcation repair material. Due to its favorable cost, ready availability, and almost similar outcome as bioceramics, MTA is considered as an alternative to Endosequence and is the gold standard in furcation repair., Competing Interests: There are no conflicts of interest.

Aim: The study evaluated the antibacterial effects of dental restorations such as nano-hybrid composite (Empress), a glass ionomer cement (GIC Gold label Type 9) and silver amalgam against Streptococcus mutans ., Materials and Methods: A modified bacterial suspension within the material assay was used to study the antibacterial effects. A volume of 20 μl of bacterial suspensions were placed in a narrow conical cavity within the materials. They were incubated for 0, 3, 6, 12, 24, and 48 h at 37°C. After the incubation period, the number of viable cells in the suspension was evaluated. In liquid culture assay, growth inhibition was measured at A600 nm up to 6 h in bacterial suspensions treated with the eluates of the restorative materials., Statistical Analysis: Kruskal-Wallis test and Mann-Whitney's test were performed to determine the significant differences between the control and restorative materials for given incubation periods at 5% level of significance ( P < 0.05)., Results and Conclusion: After 6 h of incubation, all restorative materials showed an inhibitory effect when compared to the controls. Silver amalgam showed the highest inhibition, followed by GIC Type 9 and composite. Silver amalgam showed marked inhibition after 2 h in comparison to the other material groups. These techniques employed to study the antibacterial effects showed that the silver amalgam had the pronounced inhibitory effect followed by GIC and composite. Further research on these aspects is necessary to determine whether the material can prevent secondary caries formation., Competing Interests: There are no conflicts of interest.

Aim: The aim of this study is to evaluate the protective effect of the salivary proteins on the demineralization of enamel., Materials and Methods: Twenty freshly extracted human molar teeth were used in this study. Enamel samples (2 mm thickness) were prepared from the buccal and lingual surfaces of the teeth selected. An acid-resistant nail varnish was used to cover every aspect of the sample, except an area of 5 * 5 mm limited by an adhesive tape. After drying, the adhesive tape was removed, exhibiting a rectangular area on the enamel surface. Samples were divided into two groups: Group I (10 samples): Each sample was coated by 100 μg of albumin for 2 hours at 37°C. Group II (10samples): Each sample was exposed to 100 μL of deionized water.Samples were washed by dipping once in deionized water. They were then disposed into individual tubes containing demineralization solution for 1, 2, 3, and 4 minutes at 37°C with gentle agitation. The demineralization solution was utilized to determine the calcium loss from specimens at 1, 2, 3, 4 minutes using an ultraviolet-visible spectrophotometer., Results: Calcium loss was less from the albumin-coated samples than control group at all times and was statistically significant (p < 0.05). Also, calcium loss was maximum at the end of 1 minute, and it decreased as time interval increased and was statistically significant (p < 0.001)., Conclusion: Albumin has provided a strong protection against enamel demineralization at all times compared to the one without it., How to Cite This Article: Hegde MN, Sajnani AR. Salivary Proteins-A Barrier on Enamel Demineralization: An in vitro Study. Int J Clin Pediatr Dent 2017;10(1):10-13., Competing Interests: Source of support: Nil Conflict of interest: None

Aim: To ascertain the role of Enterococcus faecalis in persistent infection and a possible method to prevent the penetration of E. faecalis into root cementum., Methodology: One hundred and twenty human single-rooted extracted teeth divided into five groups. Group I (control): intact teeth, Group II: no apical treatment done, Group III divided into two subgroups. In Groups IIIa and IIIb, root apex treated with lactic acid of acidic and neutral pH, respectively. Group IV: apical root cementum exposed to lactic acid and roughened to mimic the apical resorption. Group V: apical treatment done same as Group IV and root-end filling done using mineral trioxide aggregate (MTA). Apical one-third of all samples immersed in E. faecalis broth for 8 weeks followed by bone morphogenetic protein and obturation and again immersed into broth for 8 weeks. Teeth split into two halves and observed under confocal laser scanning microscope and scanning electron microscope, organism identified by culture and polymerase chain reaction techniques., Results: Adhesion and penetration was observed in Group IIIa and Group IV. Only adhesion in Group II and IIIB and no adhesion and penetration in Group I and V., Conclusion: Adhesion and penetration of E. faecalis into root cementum providing a long-term nidus for subsequent infection are the possible reason for persistent infection and root-end filling with MTA prevents the adhesion and penetration., Competing Interests: There are no conflicts of interest.

Aim and Objectives: To evaluate the elution of bisphenol A-glycidyl methacrylate (BisGMA) and triethylene glycol dimethacrylate (TEGDMA) from two bulk-fill composites at different polymerization times, for different storage periods when cured with quartz-tungsten-halogen (QTH) curing unit., Materials and Methods: Tetric N-Ceram bulk fill and EverX Posterior were analyzed using high-performance liquid chromatography unit. Totally, 68 samples were prepared, two groups (n = 17) from both the composites, one for each tested polymerization time. Each sample was cured with a QTH curing unit, using soft-start curing technique and stored in 2 ml of ethanol for 24 h. Storage medium was renewed and then stored again for 1 week. Data acquired were statistically analyzed., Results: The elution of BisGMA was significantly higher from Tetric N-Ceram bulk fill and BisGMA and TEGDMA from EverX Posterior composite at the end of 24 h, irrespective of the curing time. In EverX Posterior, a higher amount of TEGDMA was eluted at the end of 24 h, while at the end of 1 week, significantly higher amount of BisGMA was released., Conclusion: A significant amount of the release of BisGMA as well as TEGDMA was seen from both the composites when stored for different time intervals.

Background: One of the most critical and crucial steps in surgical extraction is cutting the bone or osteotomy, for which many techniques are used, e.g., chisels and mallet, rotary instruments, and ultrasound bone-cutting instruments. If they are not used judiciously, they can be hazardous., Objectives: To assess the efficiency of piezosurgery unit over micromotor while performing surgical extraction of lower third molars by assessing the time taken for the surgery and measuring postoperative parameters such as pain, trismus, and swelling., Materials and Methods: Thirty patients having bilateral impacted third molars with the same difficulty index were selected for the study. One side surgical removal was done using micromotor and other side by piezosurgery with an interval of 15 days. After each surgery, time taken to finish was measured and patients were followed up on postoperative days 1, 3, 5, 7, and 15 for assessing pain, trismus, and swelling. Data obtained were statistically analyzed., Results: The mean time taken for the micromotor group is 37.90 min whereas by the piezosurgery group is 54.63 min, showing a statistically significant difference ( P < 0.001). Furthermore, there is statistically significant difference ( P < 0.001) in the level of pain, trismus, and swelling on postoperative days 1, 3, 5, and 7. Even the intragroup comparison of piezosurgical group for trismus and swelling showed no statistically significant difference on postoperative day 7, indicating faster recovery of trismus and swelling. On postoperative day 15, there was no difference in any parameter in both groups indicating complete symptom-free recovery in both groups., Conclusion: It takes more time to perform surgical extraction of third molars when piezosurgical unit is used. Despite that, it causes less pain postoperatively with faster improvement in trismus and quicker reduction in swelling., Competing Interests: There are no conflicts of interest.

Context: Incipient carious lesions are characterized by subsurface dissolution due to more fluoride ions in the 50-100 microns of the tooth's outer surface., Aims: To determine an optimal power setting for 810 nm aluminum gallium arsenide laser for caries inhibition., Materials and Methods: Fifty-four caries-free extracted teeth were sectioned mesiodistally. The samples were divided into 18 groups for each power setting being evaluated. Each group had six samples. The laser used is 810 nm aluminum gallium arsenide laser with power setting from 0.1 watts to 5 watts. Laser fluorescence based device was used to evaluate the effect of irradiation., Statistical Analysis Used: Paired "t" test, one-way analysis of variance (ANOVA), Tukey's post hoc test, and the Pearson's correlation test., Results: The paired t-test showed that there is minimum divergence from the control for 3.5 watts. Tukey's post hoc test also showed statistically significantly results for 3.5 watts. The Pearson's correlation test showed that there was negative correlation between the watts and irradiation., Conclusions: The power setting that gave statistically significant results was 3.5 watts.

The TRMM rainfall product 3B42 is compared with rain gauge observations for Kaiga, India on monthly and seasonal time scales. This comparison is carried out for the years 2004-2007 spanning four monsoon seasons. A good correlation is obtained between the two data sets however; magnitude wise, the cumulative precipitation of the satellite product on monthly and seasonal time scales is deficient by almost 33-40% as compared to the rain gauge data. The satellite product is also compared with APHRODITE's Monsoon Asia data set on the same time scales. This comparison indicates a much better agreement since both these data sets represent an average precipitation over the same area. The scavenging coefficients for (131)I and (137)Cs are estimated using TRMM 3B42, rain gauge and APHRODITE data. The values obtained using TRMM 3B42 rainfall data compare very well with those obtained using rain gauge and APHRODITE data., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objectives. To evaluate and compare the antifungal efficacy of 1.3% NaOCl/MTAD with 2.5% sodium hypochlorite (NaOCl), 2% chlorhexidine gluconate (CHX), and iodine potassium iodide (IKI). Materials and Methods. Fifty-two single rooted teeth were used which were divided into four groups with 10 teeth in each group: 2.5% NaOCl, 2% CHX, IKI, 1.3% NaOCl/MTAD, and physiologic saline. Two teeth served as negative controls and were placed in fresh brain-heart infusion broth (BHI) after autoclaving. The teeth were inoculated and incubated with Candida albicans after which the teeth were instrumented and irrigated with the test irrigants. The first microbial sampling was then performed and colony forming unit/mL (cfu/mL) was counted. The second microbial sampling was performed 1 week after instrumentation and irrigation. Results. The test irrigants were effective against C. albicans in both the first and second microbial samplings. When the irrigants were compared, there was no statistical difference in their activity in the 1st and 2nd microbial sampling. On comparison of the change in mean cfu/mL between the 1st and 2nd microbial samplings, the antifungal activity of the test irrigants was in the order 2.5% NaOCl > 2% CHX > 1.3% NaOCl/MTAD > IKI.

Background: Diabetes Mellitus is a metabolic syndrome, affecting the oral health in various ways with dental caries being one of the most common problems encountered. Saliva is one of the most abundant secretions in the human body with a variety of natural protective and defence molecules bathing the oral cavity maintaining equilibrium. Its collection is easy and non-invasive., Aims: To compare and evaluate salivary alkaline phosphatase levels and calcium ion levels between caries active type II diabetes mellitus patients and non-diabetics., Materials and Methods: This study was carried out on caries-active age and gender matched 60 non-diabetic and 60 patients with known Type II diabetes mellitus subjects of age group 25-50 years with DMFT index >10. Saliva sample was collected to analyse for alkaline phosphatase enzyme and concentration of calcium ions using Agappe kits., Statistical Analysis: Student 't' test was used to correlate the salivary electrolyte concentration in non- diabetic and diabetic patients with dental caries. A 'P' value of 0.05 or less was considered significant. Results are presented as mean ± standard deviation (X ± SD)., Results: The alkaline phosphatase (ALP) activity in saliva was higher in diabetic patients when compared to that of non-diabetic patients with salivary calcium ions were significantly higher in non-diabetic individuals., Conclusion: Diabetes Mellitus patients are more prone to dental caries, hence require intervention to improve the quality of saliva.

Aim: The aim was to determine the effect of four different intracanal medicaments on the apical seal of the root canal system in vitro., Methodology: Fifty freshly extracted intact human permanent maxillary central incisors were collected, stored and disinfected. The root canals were prepared to a master apical size of number 50 using step back technique. Depending upon the intracanal medicament used, the teeth were divided randomly into five groups of 10 teeth each including one control group and four experimental groups. Group A: No intracanal medicament. Group B: Calcium hydroxide powder mixed with distilled water. Group C: Calcium hydroxide gutta percha points (calcium hydroxide points). Group D: 1% chlorhexidine gel (hexigel). Group E: Chlorhexidine gutta percha points (Roeko Activ Points). The medication was left in canals for 14 days. Following removal of the intracanal medicament, all the groups were obturated with lateral compaction technique. The apical leakage was then evaluated using dye extraction method with the help of a spectrophotometer., Results: RESULTS were statistically analyzed using Kruskal-Wallis and Mann-Whitney U-test, which showed statistically significant difference among the five groups tested., Conclusion: It can be concluded from this study that the control group showed least amount of leakage, whereas the 1% chlorhexidine gel group showed maximum amount of leakage. Apical leakage was observed with all the experimental groups with little variations in between them. Under the parameters of this study, it can be concluded that use of intracanal medicaments during endodontic treatment has a definite impact on the apical seal of the root canal system.

Background: Conventional radiographic techniques being two dimensional, has its restrictions and is confined to limited diagnostic value. However, the incorporation of Cone Beam Computed Tomography (CBCT) gives a three dimensional insight to the tooth morphology and leads to better evaluation and treatment management., Aim: The aim of this study was to evaluate and assess the root canal morphology of mandibular pre-molars in South Indian Population using CBCT radiographic technique., Materials and Methods: One thousand and eighty six and 814 fully erupted mandibular first and second premolars respectively were scanned using CBCT to evaluate the canal morphology according to Vertucci and Gulabiwala's classification., Results: The most common configuration in mandibular first and second premolars was Vertucci's Type I(83.81% and 93.48% respectively) followed by Type V (11.97% and 3.5% respectively)., Conclusion: South Indian population presented Type IV ertucci's canal morphology as the most common in mandibular first and second pre-molars followed by Type V. CBCT scanning poses a greater advantage in assessing the complexity of root canal morphology and planning an appropriate endodontic treatment for the same.

Mandibular first molar commonly has two roots, the mesial and the distal root. Surprisingly in some mandibular first molar has an unusual extra third root in between mesial and distal root. This extra root is the most commonly seen in lingual side and is called as radix entomolaris. If this extra root is seen on the buccal side, it is termed as radix paramolaris (RP), which is a very rare phenomenon. Recently, various case report studies has shown the presence of third canal in the mesial and distal roots of mandibular molars. They are named as middle mesial and middle distal canal, respectively. Here, we present a case report of mandibular second molar showing three canals in the mesial root and a RP.

Aim: The aim of this study is to address the cause of persistent infection of root cementum by Enterococcus faecalis., Materials and Methods: A sample of 60 human single-rooted teeth were divided into three groups. Group I (control group) had no access opening and one-third of the apical root cementum was sealed using varnish. Group II had no preparation of teeth samples. In group III, apical root cementum was exposed to organic acid and roughened using diamond point to mimic apical resorption. After access opening in groups II and III, all teeth samples were sterilized using gamma irradiation (25 kGy). E. faecalis broth was placed in the root canal and apical one-third of the tooth was immersed in the broth for 8 weeks with alternate day refreshment followed by biomechanical preparation, obturation and coronal seal. Apical one-third of all teeth samples were again immersed in the broth for 8 weeks with alternate day refreshment to mimic secondary infection. The samples were observed under a confocal microscope after splitting the teeth into two halves., Results: E. faecalis penetrated 160 μm deep into the root cementum in group III samples and only showed adhesion in group II samples., Conclusion: Penetration and survival of E. faecalis deep inside the cementum in extreme conditions could be the reason for persistent infection.

This study evaluated the superoxide dismutase (SOD) activity, copper and zinc levels in saliva of caries-active and caries-free individuals. Eighty healthy adults were divided according to WHO criteria: caries-free (DMFT = 0) and caries-active (DMFT >10). Saliva collected was estimated for SOD activity as well as copper and zinc levels using the atomic nitro blue tetrazolium chloride reduction method and absorption spectrophotometry, respectively. The Student t test was applied. In conclusion, SOD activity as well as copper and zinc levels increased in the caries-active group and showed statistically significant results.

Aim: The aim of this study is to evaluate the enamel remineralization after treatment with three different remineralizing agents using surface microhardness assessment., Materials and Methods: This in vitro study involves 50 enamel samples divided into five groups of 10 samples each. The positive control group consisted of intact enamel and a negative control group consisted of demineralized enamel samples. All groups excluding the positive control group were subjected to demineralization following which three of these groups were remineralized using remineralizing agents (casein phosphopeptide amorphous calcium phosphate [CPP-ACP] [GC tooth mousse], casein phosphopeptide amorphous calcium phosphate with fluoride [CPP-ACPF] [GC tooth mousse plus], sodium fluoride [phos-flur]). The groups treated with remineralizing agents were subjected to pH cycling over a period of 28 days. This was followed with assessment of surface microhardness (Micro Vickers Hardness tester, Matsuzawa Co., Ltd, Toshima, Japan)., Statistical Analysis: One-way analysis of variance test and posthoc Tukey test were conducted for multiple group comparison., Results: There was an improved enamel remineralization in the group, remineralized using CPP-ACPF in comparison with the other groups., Conclusion: Casein phosphopeptide with fluoride is a promising material for remineralization of enamel subsurface lesions.

Background: Human immunodeficiency virus (HIV) causes severe immunosuppression due to progressive decrease in the CD4 T lymphocyte cells during the course of the disease and this affects all the body systems including glandular secretions. A number of lesions affecting the salivary glands have been noted in HIV infection. The objective of this study was to evaluate the salivary pH and the buffering capacity in HIV positive individuals and comparing it with the HIV negative healthy individuals., Materials and Methods: The study was carried out on 200 HIV positive subjects aged 20-40 years, divided into two groups on the basis of CD4 count and 100 HIV negative healthy individuals as control group. Both unstimulated and stimulated saliva were collected and the pH and buffering capacity ascertained using the saliva check kit. (GC Asia Dental Pvt. Ltd., Singapore, 508724)., Results: All the three groups were compared using the ANOVA and it was found there was highly significant decrease in pH and buffering capacity with increase in immunosuppression. The intergroup comparison was carried out using the Tukey honestly significant difference (HSD) and the Chi square test. Group 1; CD4 count <200 and Group 2, CD4 count >200 showed a significant decrease in unstimulated salivary flow, stimulated salivary flow, and pH in comparison to HIV negative individuals; however, change in buffering capacity in Group 2 was not significant., Conclusion: There is a decrease in pH and buffering capacity in HIV infected patients. This decrease may be one of the factors responsible for increased caries in HIV infected population.

Context: Oxidative stress is defined as an imbalance between the production of reactive oxygen species and antioxidant defense systems which are widely recognized as an important feature of many diseases including dental caries, suggesting that total antioxidant status may be of importance in determining the progression of caries., Aim: The aim of this study was to estimate the total antioxidant capacity (TAC) in saliva and serum of caries-free and caries-active adults and to correlate the TAC level with DMFT index (D = decayed, M = missing, F = filled, T = teeth)., Settings and Design: The present study included 100 healthy adults who were divided into four groups: Control, group I, group II, and group III, with a DMFT index 0, <3, <10, and >10, respectively., Materials and Methods: Saliva and serum samples were collected from all the four groups. The TAC of saliva and serum was estimated by phosphomolybdenum method., Statistical Analysis Used: One-way analysis of variance (ANOVA) was used to compare the TAC of saliva and serum. Only differences with "P" < 0.05 were considered statistically significant., Results: The mean TAC level of both saliva and serum increased significantly (P < 0.001) with the DMFT index., Conclusion: Total antioxidant capacity of saliva has a linear relation with caries, i.e., as the severity of caries increases, the TAC level also increases.